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Lindner, M; Arefnia, B; Ivastinovic, D; Sourij, H; Lindner, E; Wimmer, G.
Association of periodontitis and diabetic macular edema in various stages of diabetic retinopathy.
Clin Oral Investig. 2022; 26(1):505-512 Doi: 10.1007/s00784-021-04028-x [OPEN ACCESS]
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Leading authors Med Uni Graz

Lindner Marlene

Co-authors Med Uni Graz

Arefnia Behrouz

Ivastinovic Domagoj

Lindner Ewald

Sourij Harald

Wimmer Gernot

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Abstract:

OBJECTIVES: Periodontitis and diabetes are known to have a bidirectional relationship. Diabetic macular edema is a complication of diabetes that is strongly influenced by inflammatory pathways. However, it remains to be established whether inflammation at other locations, such as periodontitis, affects diabetic macular edema. Here, we investigated the prevalence of periodontitis in patients treated for diabetic macular edema. MATERIALS AND METHODS: Patients with diabetic macular edema were recruited for this cross-sectional study at the Medical University of Graz. Macular edema was documented by optical coherence tomography. Periodontal status was assessed by computerized periodontal probing and panoramic X-ray imaging. Bleeding on probing, clinical attachment level, probing pocket depth, and plaque index were compared between different stages of diabetic retinopathy. RESULTS: Eighty-three eyes of 45 patients with diabetic macular edema were enrolled. Forty-four eyes (53.0%) had early stages of diabetic retinopathy (mild and moderate), and 39 eyes (47.0%) had late stages (severe and proliferative). Patients with mild or moderate DR were more likely to have more severe periodontal conditions than patients with severe or proliferative DR. Fourteen patients with mild DR (82.4%), 7 patients with moderate DR (87.5%), 4 patients with severe DR (100.0%), and 15 patients with proliferative DR (93.8%) had some degree of PD. The periodontal inflamed surface areas and the percentages of tooth sites that bled on probing were significantly higher in patients with early stages of diabetic retinopathy than in those with late stages of the disease (p < 0.05). Patients with periodontal inflamed surface areas of more than 500 mm² required significantly more intravitreal injections in the last year than those with milder forms of periodontitis (n = 6.9 ± 3.1 versus n = 5.0 ± 3.5, p = 0.03). CONCLUSION: In patients with diabetic macular edema, periodontitis is more prevalent in early stages of diabetic retinopathy. We suggest regular dental check-ups for diabetic patients, especially when diabetic macular edema is already present. CLINICAL RELEVANCE: Patients with diabetic macular edema should be screened for periodontitis and vice versa, particularly early in the course of diabetes.

Find related publications in this database (using NLM MeSH Indexing)

Cross-Sectional Studies - administration & dosage

Diabetes Mellitus - administration & dosage

Diabetic Retinopathy - epidemiology

Humans - administration & dosage

Macular Edema - epidemiology, etiology

Periodontitis - complications, epidemiology

Tomography, Optical Coherence - administration & dosage

Find related publications in this database (Keywords)

Periodontitis

Diabetic macular edema

Diabetic retinopathy

Periodontal inflamed surface area

Optical coherence tomography

Clinical attachment level

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